Observations of the Medical Officer of Health [E.W. Hope] upon the report of Dr. R.J. Reece to the Local Government Board on smallpox and smallpox hospitals at Liverpool, 1902-3.

  • Hope, E. W. (Edward William), 1855-1950
Date:
1905
Catalogue details

Licence: In copyright

Credit: Observations of the Medical Officer of Health [E.W. Hope] upon the report of Dr. R.J. Reece to the Local Government Board on smallpox and smallpox hospitals at Liverpool, 1902-3. Source: Wellcome Collection.

Provider: This material has been provided by Royal College of Physicians, London. The original may be consulted at Royal College of Physicians, London.

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    the coiisideiations u])on which so much stress is laid by Mr. IVjwer and other observers, and makes no I'eference wliatever to the volume of proof laid before him as to other definite sources of infection. He says (page 9);—“ Tlie generally accepted, and so far as 1 am aware the only completely satisfactory, explanation of the peculiarities of small})Ox incidence around hospitals i-eceiving acute cases of the disease, is dissemination of infection l>y aerial convection.” It must at once be pointed out that the statement that the theory is generally accepted is without justification. The theoiy is not genei'ally accepted by experts; it is not generally acce]>ted by Medical Officers of Healtli, and it has been rejected by the Higli Courts of J ustice, both in Ireland and in England, when the theory has been put forward with a view to restrain the use of certain sites for smallpox hos})ital purposes. The latest important case in point may be I'eferred to. An action, which occupied the attention of the Chancery Division of the High Court for an entire week, was brought against the Corj^oration of Nottingham, to prevent the use of a site for a, smallpox hospital, the op])Osition practically resting upon the question of aerial convection, the evidence brought in suppoit of it being clearly and ably put by eminent counsel; but the leai'iied Judge, Mr. Justice Farwell, who tried the case, having heard evidence of both sides, said in regard to this question of aerial convection, “if the case had i-ested on the plaintiffs’ evidence alone, I should have had great difficulty in adopting the conclusions as sufficiently proved ” ; he also observed, “ with regard to the plaintiffs’ historical instances, if I may so call them, they have already figured in former actions . . . and have never been accepted as sufficient.” It is not, however, the intention in these obsei'vations to discuss the theory of aerial convection, but to state fully the facts of the case, which will leave no doubt whatever that so far as the Liverpool outbreak is concerned, the extension was due to other ascertained causes, and the hospitals themselves contributed in no way to the spread of the disease. METHOD ADOPTED. Dr. 11 eece describes the method he has followed in carrying out the investigation in the following tei'ins;— “ In order to study the facts as regards Liverpool, I prepared from the large scale map made for me in the City Engineer’s Office, ‘ spot ’ maps of Liverpool, in fortnightly periods, showing the position of the smallpox-invaded houses from the time that the first cases of smallpox occurred in the City in December, 1901, until the end of the epidemic in 190J. Certain of these maps are appended to this report. No case of smallpox that was imported into liie town from the shipping, and no case brought by tramps, have been taken into consideration when the smallpox has developed witliin less than two weeks of such persons’ arrival in Liverpool. Persons in this category clearly did not acquire their infection in the City of Liverpool. On the appended maps invaded houses are alone indicated, and no house that during the epidemic was once infected has been, on secondary cases occurring in it, again
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